成人难治性破伤风的诊断与治疗分析

Diagnosis and treatment of adult patients with refractory tetanus

目的探讨成人难治性破伤风的临床表现与治疗方法。方法回顾性分析5例成人难治性破伤风患者的病历资料。结果 5例患者综合治疗效果不佳,再次对患者所有伤口进行反复清创,并加用头孢三代抗生素,同时延长破伤风抗毒素使用疗程,4例痊愈,1例死亡。结论应积极控制成人难治性破伤风患者的肺部感染,反复搜寻患者的感染灶并进行彻底清创,必要时可多次使用破伤风抗毒素进行治疗。

Objective To explore the clinical manifestations and therapeutic methods of adults with refractory tetanus. Meth- ods We retrospectively analyzed medical records of the 5 aduh patients with refractory tetanus. Results At the beginning, no satisfac- tory curative effects were obtained after we adopted a variety of treatment methods,including intravenous injection TIG or TAT, nutrition supporting,ventilator, sedative and muscle loose agent. Afterwards, we performed repeated debridement and added cephalosporins of three generation antibiotics. Meanwhile,we extended use of treatment of tetanus antitoxin. As a result,4 patients recovered and one case died. Conclusions The doctor should actively control pulmonary infection for adult patients with refractory tetanus, repeatedly search all possible focus of infection and thoroughly debride. It should carry out the multiple use of TAT if it is necessary.